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Dr. Kamlesh  Patel  Md image

Dr. Kamlesh Patel Md

1901 Haverford Plaza Suite 109
Sun City Center FL 33573
813 343-3500
Medical School: Other - 1994
Accepts Medicare: Yes
Participates In eRX: Yes
Participates In PQRS: No
Participates In EHR: Yes
License #: ME95909
NPI: 1417990524
Taxonomy Codes:
204D00000X

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Awards & Recognitions

About Us

Practice Philosophy

Conditions

Dr. Kamlesh Patel is associated with these group practices

Procedure Pricing

HCPCS Code Description Average Price Average Price
Allowed By Medicare
HCPCS Code:95953 Description:EEG monitoring/computer Average Price:$525.35 Average Price Allowed
By Medicare:
$155.68
HCPCS Code:95819 Description:Eeg awake and asleep Average Price:$320.13 Average Price Allowed
By Medicare:
$53.82
HCPCS Code:93880 Description:Extracranial study Average Price:$294.18 Average Price Allowed
By Medicare:
$177.59
HCPCS Code:95861 Description:Muscle test 2 limbs Average Price:$230.90 Average Price Allowed
By Medicare:
$136.58
HCPCS Code:95886 Description:Musc test done w/n test comp Average Price:$147.53 Average Price Allowed
By Medicare:
$85.62
HCPCS Code:99222 Description:Initial hospital care Average Price:$190.86 Average Price Allowed
By Medicare:
$134.69
HCPCS Code:95957 Description:EEG digital analysis Average Price:$408.29 Average Price Allowed
By Medicare:
$359.14
HCPCS Code:99203 Description:Office/outpatient visit new Average Price:$150.51 Average Price Allowed
By Medicare:
$105.08
HCPCS Code:99215 Description:Office/outpatient visit est Average Price:$181.25 Average Price Allowed
By Medicare:
$139.09
HCPCS Code:99213 Description:Office/outpatient visit est Average Price:$99.67 Average Price Allowed
By Medicare:
$69.94
HCPCS Code:99204 Description:Office/outpatient visit new Average Price:$190.58 Average Price Allowed
By Medicare:
$161.11
HCPCS Code:99226 Description:Subsequent observation care Average Price:$121.00 Average Price Allowed
By Medicare:
$100.88
HCPCS Code:99223 Description:Initial hospital care Average Price:$216.95 Average Price Allowed
By Medicare:
$197.11
HCPCS Code:95934 Description:H-reflex test Average Price:$100.00 Average Price Allowed
By Medicare:
$85.91
HCPCS Code:99214 Description:Office/outpatient visit est Average Price:$116.53 Average Price Allowed
By Medicare:
$103.38
HCPCS Code:96116 Description:Neurobehavioral status exam Average Price:$100.65 Average Price Allowed
By Medicare:
$89.44
HCPCS Code:95860 Description:Muscle test one limb Average Price:$102.51 Average Price Allowed
By Medicare:
$93.40
HCPCS Code:99225 Description:Subsequent observation care Average Price:$77.42 Average Price Allowed
By Medicare:
$70.07
HCPCS Code:95816 Description:Eeg awake and drowsy Average Price:$322.17 Average Price Allowed
By Medicare:
$315.36
HCPCS Code:95900 Description:Motor nerve conduction test Average Price:$68.60 Average Price Allowed
By Medicare:
$62.25
HCPCS Code:95904 Description:Sense nerve conduction test Average Price:$60.44 Average Price Allowed
By Medicare:
$54.18
HCPCS Code:95903 Description:Motor nerve conduction test Average Price:$77.88 Average Price Allowed
By Medicare:
$71.85
HCPCS Code:99219 Description:Initial observation care Average Price:$128.99 Average Price Allowed
By Medicare:
$127.84
HCPCS Code:99233 Description:Subsequent hospital care Average Price:$101.48 Average Price Allowed
By Medicare:
$100.43
HCPCS Code:99232 Description:Subsequent hospital care Average Price:$70.60 Average Price Allowed
By Medicare:
$69.94
HCPCS Code:96120 Description:Neuropsych tst admin w/comp Average Price:$81.34 Average Price Allowed
By Medicare:
$81.34
HCPCS Code:96103 Description:Psycho testing admin by comp Average Price:$55.80 Average Price Allowed
By Medicare:
$55.80

HCPCS Code Definitions

99225
Subsequent observation care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is responding inadequately to therapy or has developed a minor complication. Typically, 25 minutes are spent at the bedside and on the patient's hospital floor or unit.
99223
Initial hospital care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission are of high severity. Typically, 70 minutes are spent at the bedside and on the patient's hospital floor or unit.
99222
Initial hospital care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission are of moderate severity. Typically, 50 minutes are spent at the bedside and on the patient's hospital floor or unit.
99219
Initial observation care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission to "observation status" are of moderate severity. Typically, 50 minutes are spent at the bedside and on the patient's hospital floor or unit.
99203
Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.
99226
Subsequent observation care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is unstable or has developed a significant complication or a significant new problem. Typically, 35 minutes are spent at the bedside and on the patient's hospital floor or unit.
95819
Electroencephalogram (EEG); including recording awake and asleep
95816
Electroencephalogram (EEG); including recording awake and drowsy
93880
Duplex scan of extracranial arteries; complete bilateral study
95860
Needle electromyography; 1 extremity with or without related paraspinal areas
95861
Needle electromyography; 2 extremities with or without related paraspinal areas
96120
Neuropsychological testing (eg, Wisconsin Card Sorting Test), administered by a computer, with qualified health care professional interpretation and report
95886
Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; complete, five or more muscles studied, innervated by three or more nerves or four or more spinal levels (List separately in addition to code for primary procedure)
95953
Monitoring for localization of cerebral seizure focus by computerized portable 16 or more channel EEG, electroencephalographic (EEG) recording and interpretation, each 24 hours, unattended
96116
Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities), per hour of the psychologist's or physician's time, both face-to-face time with the patient and time interpreting test results and preparing the report
99233
Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is unstable or has developed a significant complication or a significant new problem. Typically, 35 minutes are spent at the bedside and on the patient's hospital floor or unit.
96103
Psychological testing (includes psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology, eg, MMPI), administered by a computer, with qualified health care professional interpretation and report
95957
Digital analysis of electroencephalogram (EEG) (eg, for epileptic spike analysis)
99215
Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 40 minutes are spent face-to-face with the patient and/or family.
99214
Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
99204
Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.
99213
Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 15 minutes are spent face-to-face with the patient and/or family.
99232
Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is responding inadequately to therapy or has developed a minor complication. Typically, 25 minutes are spent at the bedside and on the patient's hospital floor or unit.

Medical Malpractice Cases

None Found

Medical Board Sanctions

None Found

Referrals

NPI
Doctor Name
Specialty
Count
1235147182
Family Practice
9,456
1588612337
Internal Medicine
8,687
1932163888
Internal Medicine
7,158
1801813829
Internal Medicine
3,743
1730137118
Internal Medicine
3,702
1942255062
Diagnostic Radiology
2,950
1003956616
Internal Medicine
2,615
1053345306
Gastroenterology
1,804
1306866058
Cardiovascular Disease (Cardiology)
1,661
1952441719
Internal Medicine
1,457
*These referrals represent the top 10 that Dr. Patel has made to other doctors

Publications

Comparison of Direct and Digital Measures of Cranial Vault Asymmetry for Assessment of Plagiocephaly. - The Journal of craniofacial surgery
Measurement of cranial vault asymmetry (CVA) is a common feature in the treatment of patients with deformational plagiocephaly (DP). In many cases, this measure is the primary marker of improvement. CVA is typically measured with calipers and is subject to interrater variability. There is little research comparing results of calipers with those of three-dimensional (3D) photogrammetry.Fifty nine visits were made by 51 children previously diagnosed with DP. Thirty eight were male and 13 were female. Thirty one of the visits included a 3D photograph. Direct measures were obtained by 2 experienced anthropometrists and included head length, width, circumference, and CVA. Their results were compared to digital measures including measures unobtainable with calipers, asymmetry of head circumference and global asymmetry.The interrater reliability of all caliper measures was excellent (intraclass correlation coefficients > 0.94). Caliper and digital measures of length, width, cephalic index, and circumference were strongly correlated (R > 0.90). There was a consistent bias, caliper measures being 1 to 4 mm shorter than their digital analogues. Caliper measured CVA was highly correlated (R > 0.90) with the directly corresponding digital measures. It was poorly correlated with measures of overall hemispheric asymmetry (R < 0.10).The cranial measurements of children with DP taken independently by 2 experienced anthropometrists showed excellent interrater reliability. Caliper measures are consistently smaller than the digital measures, presumably due to pressure of the calipers and/or the use of skullcaps during photography. Like circumference and other assessments, cranial vault asymmetry measures correlate well with their analogous digital measurements.
Maxillomandibular Fixation by Plastic Surgeons: Cost Analysis and Utilization of Resources. - Annals of plastic surgery
Maxillomandibular fixation (MMF) can be performed using various techniques. Two common approaches used are arch bars and bone screws. Arch bars are the gold standard and inexpensive, but often require increased procedure time. Bone screws with wire fixation is a popular alternative, but more expensive than arch bars. The differences in costs of care, complications, and operative times between these 2 techniques are analyzed.A chart review was conducted on patients treated over the last 12 years at our institution. Forty-four patients with CPT code 21453 (closed reduction of mandible fracture with interdental fixation) with an isolated mandible fracture were used in our data collection. The operating room (OR) costs, procedure duration, and complications for these patients were analyzed.Operative times were significantly shorter for patients treated with bone screws (P < 0.002). The costs for one trip to the OR for either method of fixation did not show any significant differences (P < 0.840). More patients with arch bar fixation (62%) required a second trip to the OR for removal in comparison to those with screw fixation (31%) (P < 0.068). This additional trip to the OR added significant cost. There were no differences in patient complications between these 2 fixation techniques.The MMF with bone screws represents an attractive alternative to fixation with arch bars in appropriate scenarios. Screw fixation offers reduced costs, fewer trips to the OR, and decreased operative duration without a difference in complications. Cost savings were noted most significantly in a decreased need for secondary procedures in patients who were treated with MMF screws. Screw fixation offers potential for reducing the costs of care in treating patients with minimally displaced or favorable mandible fractures.
Cranial Base and Posterior Cranial Vault Asymmetry After Open and Endoscopic Repair of Isolated Lambdoid Craniosynostosis. - The Journal of craniofacial surgery
Previous studies have shown that open cranial vault remodeling does not fully address the endocranial deformity. This study aims to compare endoscopic-assisted suturectomy with postoperative molding helmet therapy to traditional open reconstruction by quantifying changes in cranial base morphology and posterior cranial vault asymmetry.Anthropometric measurements were made on pre- and 1-year postoperative three-dimensionally reconstructed computed tomography scans of 12 patients with unilateral lambdoid synostosis (8 open and 4 endoscopic-assisted). Cranial base asymmetry was analyzed using: posterior fossa deflection angle (PFA), petrous ridge angle (PRA), mastoid cant angle (MCA), and vertical and anterior-posterior (A-P) displacement of external acoustic meatus (EAM). Posterior cranial vault asymmetry was quantified by volumetric analysis.Preoperatively, patients in the open and endoscopic groups were statistically equivalent in PFA, PRA, MCA, and A-P EAM displacement. At 1 year postoperatively, open and endoscopic patients were statistically equivalent in all measures. Mean postoperative PFA for the open and endoscopic groups was 6.6 and 6.4 degrees, PRA asymmetry was 6.4 and 7.6%, MCA was 4.0 and 3.2 degrees, vertical EAM displacement was -2.3 and -2.3 millimeters, and A-P EAM displacement was 6.8 and 7.8 millimeters, respectively. Mean volume asymmetry was significantly improved in both open and endoscopic groups, with no difference in postoperative asymmetry between the 2 groups (P = 0.934).Patients treated with both open and endoscopic repair of lambdoid synostosis show persistent cranial base and posterior cranial vault asymmetry. The results of endoscopic-assisted suturectomy with postoperative molding helmet therapy are similar to those of open calvarial vault reconstruction.
Progressive Tightening of the Levator Veli Palatini Muscle Improves Velopharyngeal Dysfunction in Early Outcomes of Primary Palatoplasty. - Plastic and reconstructive surgery
Management of the levator veli palatini with intravelar veloplasty has been shown to improve speech resonance. The senior author has introduced a more aggressive procedure where the levator is separately dissected, overlapped, and tightened. This study compares resonance results from four levator management protocols: non-intravelar veloplasty, Kriens intravelar veloplasty, radical intravelar veloplasty, and overlapping intravelar veloplasty.Retrospective chart review was conducted on 252 patients who underwent primary palatoplasty with speech follow-up at 3 years of age. Velopharyngeal function was evaluated with perceptual speech examinations, and subjects were scored on a four-point scale (0 = normal resonance; 1 = occasional hypernasality/nasal emission/turbulence/grimacing, no further assessment warranted; 2 = mild hypernasality/intermittent nasal turbulence/grimacing, velopharyngeal imaging suggested; and 3 = severe hypernasality, surgical intervention recommended). Fisher's exact test was used to compare outcomes.A single surgeon performed all the non-intravelar veloplasty (n = 92), Kriens intravelar veloplasty (n = 103), and radical intravelar veloplasty (n = 31), whereas the senior author performed the overlapping intravelar veloplasty (n = 26). Cleft severity proportions were equivalent across the four methods (p = 0.28). Patients who underwent overlapping intravelar veloplasty demonstrated significantly better velopharyngeal function, and none required further imaging or secondary surgery compared with the other three procedures (p < 0.001).Speech resonance outcomes at 3 years of age are improved and need for secondary velopharyngeal dysfunction management is reduced with more aggressive levator dissection and reconstruction during primary one-stage palatoplasty. Results were best when the muscle was overlapped.Therapeutic, III.
Long-term outcomes in treatment of deformational plagiocephaly and brachycephaly using helmet therapy and repositioning: a longitudinal cohort study. - Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
Deformational plagiocephaly and/or brachycephaly (DPB) is a misshapen head presenting at birth or shortly thereafter, caused by extrinsic forces on an infant's malleable cranium. There are two treatment methods available for DPB: helmeting and repositioning. Little is known about the long-term outcomes of these two treatment options. The purpose of this study was to examine children who received helmeting or repositioning therapy for DPB as infants and compare the long-term head shape outcomes of the two groups.A longitudinal cohort study design was used to evaluate change in head shape of the two groups. One hundred children (50 helmeted, 50 repositioned) were initially evaluated at 6 months or younger for DPB. Anthropometric skull measurements taken as infants before treatment were compared with measurements taken for this study. Inclusion criteria included initial clinic visit at age 6 months or younger, evaluation by the same practitioner, and current age 2-10 years. Cephalic index and cranial vault asymmetry were calculated based on caliper measurements.Data from 100 children were evaluated for this study. Significant differences between the treatment groups in the mean change in cephalic index (p = 0.003) and cranial vault asymmetry (p < 0.001) were found; the children that used helmet therapy demonstrated greater improvement.This is one of the larger published long-term outcome studies comparing children that used helmets and repositioning to treat their DPB as infants. The data suggest that infants will have more improvement in head shape with a helmet than with repositioning.
The relative risk of fatal poisoning by methadone or buprenorphine within the wider population of England and Wales. - BMJ open
To examine the population-wide overdose risk emerging from the prescription of methadone and buprenorphine for opioid substitution treatment in England and Wales.Retrospective administrative data study.National databases for England and Wales.Drug-related mortality data were drawn from the Office for National Statistics, and prescription data for methadone and buprenorphine were obtained from the National Health Service for the years 2007-2012. During this 6-year period, a total of 2366 methadone-related deaths and 52 buprenorphine-related deaths were registered, corresponding to 17,333,163 methadone and 2,602,374 buprenorphine prescriptions issued. The analysis encompassed poisoning deaths among members of the wider population of England and Wales who consumed, but were not prescribed these medications, in addition to patients prescribed methadone or buprenorphine.Mortality risk: substance-specific overdose rate per 1000 prescriptions issued; relative risk ratio of methadone in relation to buprenorphine.During the years 2007-2012, the pooled overdose death rate was 0.137/1000 prescriptions of methadone, compared to 0.022/1000 prescriptions of buprenorphine (including buprenorphine-naloxone). The analysis generated a relative risk ratio of 6.23 (95% CI 4.79 to 8.10) of methadone in relation to buprenorphine. UK Borders Agency data were taken into consideration and revealed that only negligible amounts of methadone and buprenorphine were seized on entering UK territory between 2007 and 2012, suggesting domestic diversion.Our analysis of the relative safety of buprenorphine and methadone for opioid substitution treatment reveals that buprenorphine is six times safer than methadone with regard to overdose risk among the general population. Clinicians should be aware of the increased risk of prescribing methadone, and tighter regulations are needed to prevent its diversion.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Comparison of Traditional Versus Normative Cephalic Index in Patients with Sagittal Synostosis: Measure of Scaphocephaly and Postoperative Outcome. - Plastic and reconstructive surgery
Preoperative severity and postoperative success in cranial remodeling for patients with sagittal synostosis is measured by cephalic index (CI), but this metric does not describe the appropriateness of euryon location, a crucial consideration for aesthetic outcome. We hypothesize that CI in patients with sagittal synostosis is an inaccurate measure of scaphocephaly due to abnormal euryon position.Pre and one-year postoperative cranial CT scans of children with sagittal synostosis treated before 6 months of age by either open total calvarial reconstruction or endoscopic-assisted craniectomy and molding helmet therapy (n=10 for each) were retrospectively reviewed. The location of euryons in age-matched controls was measured as a fraction of the glabella-opisthocranion distance (Horizontal Point of Maximum Width, H-PMW) and as the fraction of nasion-vertex vertical distance (Vertical Point of Maximum Width, V-PMW). CI at this ideal location (normative CI, n-CI) as well as traditional CI (t-CI) was determined in all patients.Ideal euryon location from preoperative controls was 56% by H-PMW and 56% by V-PMW. There was no difference in mean t-CI and n-CI for controls. N-CI (60%) was significantly less than t-CI (66%) in patients preoperatively (p<0.001) and remained smaller postoperatively (68% vs. 73%) for patients who underwent open reconstruction (p<0.001). Patients treated endoscopically also had smaller n-CI (71%) than t-CI (76%) postoperatively (p<0.001).Anterocaudal displacement of euryon over the temporal bone in patients with sagittal synostosis influences cephalic index. Normative CI, assessed at ideal euryon location, is a more accurate measure of preoperative severity and postoperative outcome.
The rotary zone thermal cycler: a low-power system enabling automated rapid PCR. - PloS one
Advances in molecular biology, microfluidics, and laboratory automation continue to expand the accessibility and applicability of these methods beyond the confines of conventional, centralized laboratory facilities and into point of use roles in clinical, military, forensic, and field-deployed applications. As a result, there is a growing need to adapt the unit operations of molecular biology (e.g., aliquoting, centrifuging, mixing, and thermal cycling) to compact, portable, low-power, and automation-ready formats. Here we present one such adaptation, the rotary zone thermal cycler (RZTC), a novel wheel-based device capable of cycling up to four different fixed-temperature blocks into contact with a stationary 4-microliter capillary-bound sample to realize 1-3 second transitions with steady state heater power of less than 10 W. We demonstrate the utility of the RZTC for DNA amplification as part of a highly integrated rotary zone PCR (rzPCR) system that uses low-volume valves and syringe-based fluid handling to automate sample loading and unloading, thermal cycling, and between-run cleaning functionalities in a compact, modular form factor. In addition to characterizing the performance of the RZTC and the efficacy of different online cleaning protocols, we present preliminary results for rapid single-plex PCR, multiplex short tandem repeat (STR) amplification, and second strand cDNA synthesis.
Off-label drug use in Psychiatry Outpatient Department: A prospective study at a Tertiary Care Teaching Hospital. - Journal of basic and clinical pharmacy
Off-label drug prescribing is very common in Psychiatry. US-Food and Drug Administration has defined off-label drug as "use of drugs for the indication, dosage form, regimen, patient or other use constraint not mentioned in the approved labeling."The objective was to evaluate off-label drug use in patients attending Outpatient Department of Psychiatry.One year prospective, cross sectional study was conducted on patients attending Psychiatry Outpatient Department. Demographic data, clinical history, and complete prescription were noted in the predesigned proforma and prescriptions were analyzed for off-label drug use as per British National Formulary-2011.A total of 250 patients were enrolled with mean age 40.36 ± 12.3 years. Most common diagnosis was major depressive disorder 101 (40.4%). A total of 980 drugs (mean 3.68 ± 1.42) were prescribed out of which 387 (39.5%) were off-label. Of 250 patients, 198 (79.2%) received at least one off-label drug. Psychopharmacological agents most frequently used in off-label manner were clonazepam 31 (12.4%), lorazepam 30 (12%), and trihexyphenidyl HCl 25 (10%). Prevalence of off-label use of these three drugs was significantly higher than other off-label drugs (P < 0.0001, P < 0.0001 and P < 0.0001 respectively). Inappropriate indication was the most common category of off-label use. There was positive and significant correlation between off-label prescribing and number of drugs (r = 0.722, P ≤ 0.000). Off-label prescribing was statistically significantly higher in 21-40 year age group, but no difference was seen in any co-morbid condition or in between any psychiatric disorder.Off-label drugs use is common in psychiatric OPD in our setup. Clonazepam, lorazepam, and trihexyphenidyl HCl were the most frequently used drugs in off-label manner.
Kinetic and thermodynamic characterization of a halotolerant β-galactosidase produced by halotolerant Aspergillus tubingensis GR1. - Journal of basic microbiology
β-Galactosidase from halotolerant Aspergillus tubingensis GR1 was purified by two-step purification process comprising ammonium sulfate precipitation followed by size exclusion chromatography (SEC). The recovery of β-galactosidase after SEC was found to be 1.40% with 58.55-fold increase in specific activity. The molecular weight of β-galactosidase protein was found to be 93 kDa by SDS-PAGE. Activation energy for O-nitrophenol β-D-galactopyranoside (ONPG) hydrolysis was 32.88 kJ mol(-1) , while temperature quotient (Q10 ) was found to be 1.375. The enzyme was found to be stable over wide pH range and thermally stable at 60-65°C up to 60 min of incubation while exhibited maximum activity at 65°C with pH 3.0. Vmax , Km , and Kcat for ONPG were found to be 2000 U ml(-1) , 8.33 mM (ONPG), and 101454 s(-1) , respectively. Activation energy for irreversible inactivation Ea(d) of β-galactosidase was 100.017 kJ mol(-1) . Thermodynamic parameters of irreversible inactivation of β-galactosidase and ONPG hydrolysis were also determined. However, β-galactosidase enzyme activity was activated significantly in the presence of 15% NaCl and hence shows activity up to 30% NaCl concentration.© 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

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1901 Haverford Plaza Suite 109 Sun City Center, FL 33573
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